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. 2023 Apr 14:17:e20220044.
doi: 10.1590/1980-5764-DN-2022-0044. eCollection 2023.

The frequency of psychotic symptoms in types of dementia: a systematic review

Rebeca Mendes de Paula Pessoa  1   2 , Madson Alan Maximiano-Barreto  2 , Letícia Lambert  3 , Érica Dayanne Meireles Leite  1   2 , Marcos Hortes Nisihara Chagas  1   2   3
Affiliations

The frequency of psychotic symptoms in types of dementia: a systematic review

Rebeca Mendes de Paula Pessoa et al. Dement Neuropsychol. .

Abstract
in English, Portuguese

The frequency of psychotic symptoms in older adults is high, mainly in neurocognitive cognitions of the most varied etiologies.

Objectives: This study aimed to review the studies that analyze the frequency of the types of delusions, hallucinations, and misidentifications in dementia conditions of different etiologies.

Methods: A systematic review was conducted on August 9, 2021, in the PubMed, PsycInfo, Embase, Web of Science, and Scopus databases with the following descriptors: (dementia OR alzheimer disease OR dementia with Lewy bodies OR frontotemporal dementia OR mixed dementia OR vascular dementia OR major neurocognitive disorder OR parkinson disease dementia) AND (psychotic symptoms OR psychosis OR hallucinations OR delusions OR psychopathology OR misidentification) AND (prevalence OR epidemiology).

Results: A total of 5,077 articles were found, with a final inclusion of 35. The overall frequency of psychotic symptoms ranged from 34 to 63% in dementia conditions of the most varied etiologies. Alzheimer's disease (AD) presents more delusions and hallucinations and has a higher frequency regarding the presence of misidentifications. On the contrary, Dementia with Lewy bodies (DLB) seems to present more hallucinations, even auditory, when compared to the other dementias, concomitantly with delusions. Vascular and frontotemporal dementia present fewer psychotic symptoms than DLB and AD.

Conclusions: We identified a gap in the literature on the description of the psychotic symptoms of dementia, mainly in those of non-AD etiologies. Studies that assess the neuropsychiatric symptoms of dementias deeply might contribute in a more definite manner to the causal diagnosis of dementia.

A frequência de sintomas psicóticos em idosos é alta, principalmente em cognições neurocognitivas das mais variadas etiologias.

Objetivos: Revisar os estudos que analisam a frequência dos tipos de delírios, alucinações e erros de identificação em quadros demenciais de diferentes etiologias.

Métodos: Foi realizada uma revisão sistemática em 9 de agosto de 2021, nas bases de dados PubMed, PsycInfo, Embase, Web of Science e Scopus, com os seguintes descritores: (demência OR doença de alzheimer OR demência com corpos de Lewy OR demência frontotemporal OR demência mista OR vascular demência OU transtorno neurocognitivo maior OU demência da doença de Parkinson) E (sintomas psicóticos OU psicose OU alucinações OU delírios OU psicopatologia OU identificação errônea) E (prevalência OU epidemiologia).

Resultados: Foram encontrados 5.077 artigos, com inclusão final de 35. A frequência geral de sintomas psicóticos foi de 34 a 63% em quadros demenciais das mais variadas etiologias. A doença de Alzheimer (DA) apresenta mais delírios, alucinações e maior frequência quanto à presença de erros de identificação. Por outro lado, a demência com corpos de Lewy (DCL) parece apresentar mais alucinações, inclusive auditivas, quando comparada às demais demências, concomitantemente aos delírios. As demências vascular e frontotemporal apresentam menos sintomas psicóticos do que a DCL e a DA.

Conclusões: Identificamos lacuna na literatura quanto à descrição dos sintomas psicóticos das demências, principalmente naquelas de etiologia não DA. Estudos que aprofundem os sintomas neuropsiquiátricos das demências podem contribuir de forma mais definitiva para o diagnóstico causal da demência.

Keywords: Delusions; Dementia; Geriatric Psychiatry; Hallucinations; Prevalence; Systematic Review.

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Conflict of interest statement

Disclosure: There is no conflict of interest to declare.

Figures

Figure 1.
Figure 1.. PRISMA flowchart.
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